F68.1 vs Z76.5
F68.1 (Factitious disorder imposed on self) compared with Z76.5 (Malingerer [conscious simulation]), from the official CMS tabular data. Do not report these codes together: the official tabular list marks them Excludes1.
Can these codes be reported together?
Yes, when both are documented. F68.1 carries an Excludes2 note covering Z76.5: “person feigning illness (with obvious motivation) (Z76.5)”
Excludes2 marks distinct conditions — both may be reported when both are documented.
No — do not report together. Z76.5 carries an Excludes1 note covering F68.1: “factitious disorder (F68.1-, F68.A)”
Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).
No — do not report together. Z76.5 carries an Excludes1 note covering F68.1: “peregrinating patient (F68.1-)”
Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).
Side by side
| F68.1Factitious disorder imposed on self | Z76.5Malingerer [conscious simulation] | |
|---|---|---|
| Billing status | Non-billable header | Billable |
| Classification | F01-F99 — Mental, Behavioral and Neurodevelopmental Disorders (F01-F99) | Z00-Z99 — Factors Influencing Health Status and Contact with Health Services (Z00-Z99) |
| Definition | Factitious disorder imposed on self is a non-billable ICD-10-CM category code (F68.1). | Malingerer [conscious simulation] is a billable ICD-10-CM diagnosis code (Z76.5). |
| Includes | Compensation neurosis Elaboration of physical symptoms for psychological reasons Hospital hopper syndrome Münchausen's syndrome | Person feigning illness (with obvious motivation) |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources